Look For Opportunities To Fill The Hygiene Schedule

Due to Covid, it is likely that many patients have not had their two hygiene appointments this year. Dental benefit plans usually allow 2 cleanings per year. However, the structure of this benefit can vary.


Review your insurance verification documentation to determine whether cleanings are limited to once per 6 months or 2 per plan year. If a patients plan allows for 2 cleanings per plan year, then timing of these appointments does not matter. Because of the impact of COVID shutdowns, it may be challenging to get patients whose plan is limited to one cleaning per 6 months back for a second visit. As a result, focus on the patients that are afforded 2 cleanings per year. Many patients would happily schedule more than 2 professional cleanings annually, so get them back on the schedule for another appointment! After all, you are just helping your patients maximize their benefits!


No one is quite sure what to expect as we transition into fall. After all, 2020 continues to surprise us. To position you for success, we have posted the following practical tips to help you continue the momentum from June, July and August.

Continue to communicate PPE & other safeguards

The recently published Guardian Life Dental Benefits Survey provides extremely valuable insight.

For example, the survey showed 3 in 10 adults are more anxious about visiting the dentist after the pandemic. However, the report indicated “adults will be less anxious about in-person appointments if their dentist clearly communicates the steps taken to maintain patient safety.”

Be sure to communicate to your patients addressing these and other concerns.

We realize that many offices have already communicated this message. However, effective leaders must repeat themselves constantly to drive the message home. Here’s an example to reinforce the point. “A friend of mine once paraphrased David Gergen, saying on the subject of repetition, “If you want to get your point across, especially to a broader audience, you need to repeat yourself so often, you get sick of hearing yourself say it. And only then will people begin to internalize what you’re saying.”

The take-away here is that you can’t overcommunicate your efforts to keep your patients safe!!!


The ADA in their interim Guidance toolkit provided the attached template letter. Start with something like this. Be sure to broadcast your efforts on your website, in the office, chairside and on social media!

ADA_Welcome_Back_Reassurance_LetterDownload

On July 24, the Health & Human Services Department extended the deadline for dentists to apply for grants from the Provider Relief Fund to Monday, August 3. Through July 14 only 3,600 Medicaid, CHIP, and dental providers had applied for relief, accounting for $142 million of the $15 billion allocated. Click the link above to find out more.

The fifth and final episode in the Five Points from Five Lakes series about leaving PPO plans outlines key considerations for the entire dental team as you begin exiting PPO’s. Five Lakes Founder and President Nick Partridge highlights critical decisions to be made around the office financial policy and communication plan. In the video, Nick also discusses the importance of tracking results to be able to fine-tune your plan. Leaving PPO plans is an exciting, yet stressful exercise. Make sure you’ve thought through your plan.

This case study provides valuable insight into how Five Lakes takes a data-driven approach to advising clients through challenges.

The Five Points from Five Lakes series is designed to help educate practices about why PPO negotiations are only part of a comprehensive PPO insurance participation strategy. Your insurance participation strategy should reflect your business goals with support from market data, practice data and information about available PPO plans in your area. Five Lakes provides the most comprehensive analysis to develop the optimal plan PPO participation strategy for your practice even if that means leaving PPO plans!

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PPO negotiations are an exercise in communicating your value and focusing efforts appropriately to achieve agreement. For more than 10 years, Five Lakes has negotiated with payers to help clients achieve higher PPO reimbursements. As expert dental negotiators, our customized approach has resulted in millions of dollars of financial gain for our clients.

We are periodically challenged with the question from prospective clients, “how good are you?” or “can you do it better than me?” To answer this challenge, we wanted to share some about our process. Perhaps similar to an automobile service garage, at Five Lakes, we have a 20-point inspection.

For practices considering PPO negotiations, we will highlight some of the effort that goes into our 20-point process over the coming weeks. Today, we start with what.

What Are We Negotiating?

First, you must understand what you are trying to accomplish. What are the variables in a PPO negotiation between payer and provider?

Once you have identified your purpose to initiate a negotiation, you must next consider what you are looking to accomplish in terms of outcomes.

Managing PPO’s in a transition is complicated. Each transition has unique elements that require customized solutions. There are many aspects to a transition from processing an ownership change with insurance companies, to PPO negotiations and credentialing. Five Lakes facilitates this process for clients hundreds of times annually. In our final installment, watch Founder and President Nick Partridge walk you through a case study for a recent client.

Managing PPO’s in a transition is complicated and likely to produce scenarios where providers are out-of-network for a period of time. As a result, it is important to understand timelines, billing best practices and how to communicate with patients to manage expectations.

Dental insurance credentialing is a time-consuming process, join Five Lakes Founder and President Nick Partridge as he discusses important considerations for billing and communicating effectively with patients.

In this fourth installment, Five Lakes Founder and President Nick Partridge discusses the Five Lakes approach. The case study continues as Nick looks at the two ways Five Lakes was able to meet the clients goals. In planning to leave networks, Five Lakes was also helpful working to maximize reimbursements and streamline participation. Through PPO negotiations and optimizations, the practice would realize more than $42,000 annually while setting up to leave PPO’s. This effort helped shrink participation, which made for fewer plans to drop and also produced a substantial ROI.

This case study is a great example of how Five Lakes works with your practice to develop a roadmap to PPO freedom. Happy viewing!

The Five Points from Five Lakes series is designed to help educate practices about why PPO negotiations are only part of a comprehensive PPO insurance participation strategy. Your insurance participation strategy should reflect your business goals with support from market data, practice data and information about available PPO plans in your area. Five Lakes provides the most comprehensive analysis to develop the optimal plan PPO participation strategy for your practice.

Five Lakes Dental Practice Solutions
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PPO credentialing is a time consuming and frustrating exercise. Add in an ownership change…and multiply the fun.

Many buyers in a practice transition want to cause as little disruption as possible to patients. As a result, buyers want providers to be in-network as quickly as possible. Thus, it is important to understand dental credentialing timelines as well as the added requirement to execute a TIN change (or ownership change) in a practice transition. Given the four most common scenarios, each transition is still unique and has specific circumstances and timelines. Proper planning is key to the process.

Join Five Lakes Founder and President, Nick Partridge, as he discusses explains the nuances of completing an ownership change and PPO credentialing during a transition.

When acquiring a new practice, it is incredibly valuable to develop and implement the optimal PPO participation strategy. Oftentimes, PPO participation is a last-minute thought. As such, buyers don’t have the appropriate timeline to get it right.

Join Five Lakes Founder and President, Nick Partridge, as he discusses how to develop a PPO participation strategy in the middle of a transition.